Nuova Pedro Javier
Ocularyb Oftalmoclínica/Departamento de Oftalmología Sanatorio Modelo, Tucumán, Argentina.
Case Rep Ophthalmol. 2024 Aug 12;15(1):633-641. doi: 10.1159/000540471. eCollection 2024 Jan-Dec.
The aim of this study was to describe a very rare case of endogenous bacterial endophthalmitis caused by in both eyes with a difference in the onset of symptoms of 14 months in an immunocompetent patient.
A 66-year-old immunocompetent man presented with asynchronous bilateral endogenous endophthalmitis produced by the bacterium at the starting point of a liver abscess after cholecystectomy surgery, causing endophthalmitis 1 year and 2 months apart between an eye and another. The first was diffuse anteroposterior endophthalmitis in the left eye that ended in visual loss and phthisis bulbi due to delayed initial diagnosis and established treatment, and the second was focal endophthalmitis in the right eye that preserved the organ and resulted in a vision of 20/20 due to early suspected diagnosis and rapid instituted treatment.
To our knowledge, this is the first published case of a long asynchronous bilateral endogenous bacterial endophthalmitis caused by with a prolonged difference of 14 months in the onset of symptoms between one eye and another. This case is a vision-threatening ophthalmologic emergency that can be associated with life-threatening systemic morbidities. The early diagnosis of infection represents a challenge for clinicians, ophthalmologists, and microbiologists.
本研究的目的是描述一例非常罕见的内源性细菌性眼内炎病例，该病例发生在一名免疫功能正常的患者双眼，双眼症状发作时间相差14个月。
一名66岁免疫功能正常的男性，在胆囊切除术后肝脓肿发病时，双眼发生了由该细菌引起的不同步双侧内源性眼内炎，两眼发病间隔为1年零2个月。第一例是左眼弥漫性前后部眼内炎，由于初始诊断延误和既定治疗，最终导致视力丧失和眼球痨；第二例是右眼局灶性眼内炎，由于早期疑似诊断和迅速开始治疗，保住了眼球，视力恢复到20/20。
据我们所知，这是首例发表的由该细菌引起的长期不同步双侧内源性细菌性眼内炎病例，两眼症状发作时间相差长达14个月。该病例是一种威胁视力的眼科急症，可能伴有危及生命的全身疾病。感染的早期诊断对临床医生、眼科医生和微生物学家来说是一项挑战。
